Language Disorders:from Infancy through Adolescence:

Listening, Speaking, Reading, Writing, and Communicating

Rhea Paul, PhD, CCC-SLPProfessor, Yale Child Study Center

New Haven, Connecticut

Courtenay F. Norbury, PhD

Senior Research Fellow Department of Psychology Royal Holloway University of London London,England

pages 105-112

Williams Syndrome

definition and classification

the striking behavioral phenotype is one of overfriendliness,social gregariousness,and marked anxiety .

cognitive characteristic

language characteristics

the onset of first words and phrases is almost always delayed in WS.

form

onset of babbling is predictive of onset of word production.

content

understanding and production of concrete vocabulary are relative strengths for individuals with WS.

use

children with WS have pronounced pragmatic difficulties,despite the superficial air of social skill.

individuals with WS are less likely to provide contingent and informative responses 

literacy

reading comprehension scores are generally sinificantly lower than word reading abilities.

implications for clinical practice

intervention approaches developed for other populations with ID and social impairments can also be used for children with WS.

language intervention is likely to be necessary throughout the school years

social skills training for older children is also advocated

oral language instruction aimed at improving reading comprehension is also likely to be important

Fragile X Syndrome

definition and classification

caused by an expansion of the trinucleotide,which repeats too often on the fragile X mental retardation gene,which is located on the bottom end of the X chromosome.

boys with FXS do not have clearly dysmorhphic features and are often difficult to identify before the age of 3,unlike children with DS,whose physical features are noticeable from birth.with increasing age,characteristic physical features emerge.

cognitive characteristics

cognitive strength include simultaneous processing and long-term memory

language characteristics

girls invariably demonstrating higher levels of linguistic competence relative to males with FXS.

form

speech articulation is a relative strength,phonological processing is less well developed in FXS.

content

use

increased use of tangential language,perseverative and repetitive speech,delayed echolalia, and use of stereotyped phrases.

interventions to increase linguistic competencies should be embedded in socially meaningful contexts,with the goal of improving social interaction and pragmatic language skills.

there will be a need to work with families to decrease inappropriate communication and challenging behavior.

DLD ASSOCIATION WITH SENSORY IMPARIMENTS

visual impairment

children with congenital visual impairment may experience some early delays in the acqui-sition of language.

pragmatic skills are vulnerable in children with visual impairment .

toddlers with visual impairment delayed in their acquisition of first words and phrases.

children with visual impairment and their conversational partners may have difficulty understanding each other's referents.

the extensive,and sometimes inappropriate,use of questions;a paucity of communicative gestures;and extensive use of imitative speech,repetitions,and verbal routines.

some methods of faciliating language and social communication in this population include:

1)provide labels and descriptions of the objects the child handles and what he or her can do with these objects

2)ask both open-ended and more directive questions 

3)provide more qualitative information not only about the child's actions,but also other things going on in the environment

4)model and encourage the child to engage in pretend play 

5)engage in shared book reading activities

hearing impairment

even today,common childhood illnesses can have devastating consequences.

several factors may influence language outcome:the age at which the hearing loss occurred or was identified,the cause of hearing loss,when and how hearing amplification devices are used,the presence of medical conditions,and the child's communication environment.

sensori-neural hearing loss

cognitive characteristics

today of course we know there is no reason to assume that individuals with hearing impairment will experience intellectual impairment.

content

like language forms ,language content can vary dramatically depending on the situation.

use

learning about mental states requires rich conversational experience with others;deaf children born to deaf parents tend to outperform deaf children born to hearing parents on mearsures that tap social-cognitive understanding.

in terms of language use,early exposure to language and communication in socially meaningful contexts is more important than hearing status per se.

literacy

the early 人工耳蜗users outperformed the comparison group on all measures of reading.

children with hearing impairment exhibit more emergent literacy behaviors when they are provided with engaging,print-rich environments at home and at school,and when their early attempts at writing in these environmentas are similar in form and content to normal hearing peers.

implications for clinical practice

there is little doubt that cochlear implants have radically changed the expected outcomes for children with severe and profound hearing impairments,there is also little doubt that earlier cochlear implants use is associated with better long term outcomes.

early implantation also yields better literacy outcomes,though literacy remains a challenging area of development for children with hearing impairment.

maximising device compliance,exploring communication philosophies and options(i.e.,decisions regarding cochlear implants and sign language use)and the need for genetic testing.